Craniotomy for a Bleed

Bleeding in our around the brain (intracranial hemorrhage) can be treated by either (1) drilling “burr holes” which are large, dime-sized holes which are used to drain generally subdural bleeds (between the brain and its dura lining); or (2) connecting such holes using a drill to remove a small plate of bone called a “bone flap.” The underlying bleed can be suctioned out, and then the bone is typically replaced in a craniotomy (using small titanium plates and screws). If the bone is not replaced, then either a craniectomy (keeping the bone out without replacement) or cranioplasty (placing either mesh, bone cement, or acrylic modeled piece, as described in the “Cranioplasty” section) is performed. Of all craniotomy procedures we routinely perform, craniotomy for bleed and craniotomy for tumor are more commonly performed in our practice.